Background: Human papillomavirus (HPV) vaccine uptake is suboptimal in the US. School-based health centers (SBHCs) could improve rates of uptake by making HPV vaccination available in schools and more accessible and convenient to adolescents and families. To explore the potential of SBHCs to expand HPV vaccine uptake, we sought to determine if a pilot program to actively promote the SBHC as a venue for HPV vaccine receipt could improve HPV vaccination status.
Methods: A pilot program aimed at increasing HPV vaccine uptake was implemented at a SBHC affiliated with a hospital-based primary care center (PCC) between October 2016 – June 2017. This SBHC is located in a high school and provides vaccination services, including HPV vaccine, but no systematic protocol existed to actively identify, and target for vaccination, patients who accessed clinical services at the PCC and were also enrolled in the SBHC. Immunization status of adolescents enrolled in the SBHC who were also patients of the PCC was screened by review of the common electronic health record (EHR) that is shared between both sites. Patients were eligible for inclusion if they were in need of ≥1 dose of HPV vaccine. Eligible patients were contacted by clinic staff and offered the opportunity to receive HPV vaccine at the SBHC in accordance with usual clinic practices.
Results: Of 86 patients screened, 13 were found to be eligible for HPV vaccination at the SBHC (Figure 1). By the end of the project period, 62% of those eligible had received >1 dose of HPV vaccine (n=8) and 38% (n=5) also received another vaccine (flu, meningococcal) at the same time as HPV vaccination.
Conclusion: A pilot program consisting of determining HPV immunization status and actively offering the opportunity to receive needed doses of HPV vaccine at a SBHC resulted in improvement of vaccination status among eligible patients. Success was limited by the relatively small number of patients identified. While SBHCs may be one strategy to address missed opportunities for HPV vaccination, lack of centralized immunization records among patients who receive care from multiple providers and processes to directly communicate with parents about vaccination during school hours were identified as primary challenges.
Figure 1. Flow diagram of HPV vaccination pilot program at SBHC
A. Moriarty-Daley, None
L. M. Niccolai, Merck: Scientific Advisor , Consulting fee .